Femoral or Axillary Cannulation for Extracorporeal Circulation during Minimally Invasive Heart Valve Surgery (FAMI):...

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Procedures
• Vascular Access

Background:

• Minimally invasive heart valve surgery (MIS) is standard for valvular heart disease.
• Femoral artery cannulation is common but may increase stroke risk due to retrograde flow.
• Axillary artery cannulation offers antegrade flow as an alternative.

Purpose of the Study:

• To compare the incidence of peri-operative stroke between axillary and femoral artery cannulation.
• To evaluate the safety and efficacy of axillary versus femoral cannulation in MIS.
• To provide evidence for optimal arterial access in minimally invasive cardiac surgery.

Main Methods:

• A multicenter randomized controlled trial (FAMI) comparing axillary and femoral cannulation.
• 848 participants undergoing MIS for valvular heart disease were randomized.
• Patients were followed for 7 days postoperatively, with CT scans for vascular assessment.

Main Results:

• Evidence comparing peripheral artery cannulation methods in MIS is limited.
• Axillary cannulation may offer benefits regarding stroke risk and other complications.
• The study aims to prospectively compare stroke risks between femoral and axillary cannulation.

Conclusions:

• Further research is needed to establish the optimal cannulation strategy.
• Axillary cannulation shows potential for reduced neurological and vascular complications.
• This trial will clarify the risks associated with femoral versus axillary cannulation in MIS.